The Baby with the Bathwater

There has been so much chatter here in the UK about the "patient experience" and collecting the qualitative data to ensure a "positive patient journey." Many of the NHS guidelines focus on outcomes that embrace this idea.

That's nice. I believe that patients should have as positive an experience as possible, be treated with utmost respect, be allowed as much autonomy as possible in their treatment choices, and be empowered to call out poor practice. These qualitative measures can have a real impact on better care and outcomes.

But what about clinical measures and objective outcomes? It seems that these have become passé and no longer necessary, according to some colleagues. I've heard it said that, "Those are no longer part of the guidelines!" Hmmm. Just because the NHS has decided to focus on an area that needed improvement doesn't mean we don't bother with clinical interventions anymore, does it?

An analogy: You board an airplane, and are courteously greeted, shown to a comfortable seat with onboard entertainment that you control as you wish. The lighting works and is within your control. Your meals are exactly what you would choose and well-prepared. You're allowed to nap in peace, play games on the console, and walk about the plane at will. All in all you have a perfect passenger experience. Except for one little thing... the plane never goes anywhere. Would you pay for that? Isn't that what is being suggested by some of my colleagues? Treat patients beautifully, but don't bother getting them where they need to go.

3 comments

I treated a home health patient who received exactly as Dean and Lisa have described, and she was pleased as punch with her physical therapy experience. She made no gains, but her therapist was handsome and charismatic. How could she be okay with that? She had nothing to compare it to. She had no idea she should get better.

I came into the picture nearly two years later. She had achieved a higher functional status after two weeks working with me (post initial injury by two years and with an additional insult to boot!) than what her discharge status reflected after a completed round of therapy with him. That's when she became enraged. She said she'd like to take her newfound mobility and kick him in his keister for the months he stole from her.

I recently witnessed this same phenomenon with my daughter. I'll be posting on that at some point. It's said that love covers a multitude of sin. From what I've seen, it could also be said that kindness disguises a heap of incompetence.

Jane Goude

April 16, 2012 7:52 PM

The first part of my performance this year was to write down examples of how I have demonstrated "Kind" behaviors to my patients. Really?

If you have a kind therapist who never reduces your pain, never improves your quality of life- I hardly believe you would continue seeing that therapist. Quality and outcomes are key. "Patient experience" and "Kindness" should be common sense, human skills and not the focus.

Lisa Mueller

March 7, 2012 8:22 PM

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